Preisser John S, Arcury Thomas A, Quandt Sara A
Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, NC 27599, USA.
Am J Epidemiol. 2003 Sep 1;158(5):495-501. doi: 10.1093/aje/kwg169.
In longitudinal surveillance studies of occupational illnesses, sickness episodes are recorded for workers over time. Since observations on the same worker are typically more similar than observations from different workers, statistical analysis must take into account the intraworker association due to workers' repeated measures. Additionally, when workers are employed in groups or clusters, observations from workers in the same workplace are typically more similar than observations from workers in different workplaces. For such cluster-correlated longitudinal data, alternating logistic regressions may be used to model the pattern of occupational illness clustering. Data on 182 Latino farm workers from a 1999 North Carolina study on green tobacco sickness provided an estimated pairwise odds ratio for within-worker clustering of 3.15 (95% confidence interval (CI): 1.84, 5.41) and an estimated pairwise odds ratio for within-camp clustering of 1.90 (95% CI: 1.22, 2.97). After adjustment for risk factors, the estimated pairwise odds ratios were 2.13 (95% CI: 1.18, 3.86) and 1.41 (95% CI: 0.89, 2.24), respectively. In this paper, a comparative analysis of alternating logistic regressions with generalized estimating equations and random-effects logistic regression is presented, and the relative strengths of the three methods are discussed.
在职业疾病的纵向监测研究中，会随着时间记录工人的发病情况。由于对同一工人的观察通常比不同工人的观察更相似，因此统计分析必须考虑因工人重复测量而产生的工人内部关联。此外，当工人以群体或集群形式受雇时，同一工作场所工人的观察结果通常比不同工作场所工人的观察结果更相似。对于这种集群相关的纵向数据，可以使用交替逻辑回归来模拟职业疾病集群的模式。1999年北卡罗来纳州一项关于绿色烟草病的研究中182名拉丁裔农场工人的数据显示，工人内部集群的估计成对优势比为3.15（95%置信区间（CI）：1.84，5.41），营地内部集群的估计成对优势比为1.90（95%CI：1.22，2.97）。在对风险因素进行调整后，估计的成对优势比分别为2.13（95%CI：1.18，3.86）和1.41（95%CI：0.89，2.24）。本文对交替逻辑回归与广义估计方程和随机效应逻辑回归进行了比较分析，并讨论了这三种方法的相对优势。
